Liberty and Tolerance

I can remember a time during my medical training when I was singled out in a negative way because of my religion. It was in the operating room of a smaller community hospital where I was rotating, and I decided to work that day with a surgeon I had not met before.

“Where are you from?” he asked me.

“Utah,” I said.

“Oh, you must be a Mormon then.”

“Yes, sir, I am.”

“Then how many wives do you have?”

I was taken aback, but tried to keep smiling. “Just one,” I answered.

“Just one, huh?”

“The Church has not practiced polygamy for over 100 years,” I explained. But I suspected that he probably already knew that.

He proceeded to quiz me on the details of the procedure we were performing, and on any other tangential topic that came to his mind. If I answered a question correctly he would ask progressively harder questions until I could no longer answer. This is an old ritual in medical education known as “pimping,” which has brought countless medical students to tears and has been the subject of many treatises (my favorite is here). At the time I was a third year medical student with very little experience, and the majority of what I knew about surgery I had learned from an exceptionally boring book that I couldn’t manage to stay awake while reading. Of course I didn’t know the answers to most of his questions, and the more questions I missed the faster he asked them. It was clear that his purpose was not to educate me but to belittle me, and he took obvious pleasure in his task. After a number of uncomfortable minutes, and as the procedure was drawing to a close, he finally acknowledged in bare terms his actual purpose by telling a joke: “What is the difference between a medical student and dog [poop]?” I stared at him in disbelief for a moment before he gave his answer. “No one goes out of their way to step on dog [poop].”

I never worked with that surgeon again, and I assume that he didn’t miss me. Thankfully this experience was an exception in what was otherwise a generally tolerant and inclusive atmosphere during my medical training. Out of a few hundred doctors I interacted with over the span of nearly a decade, I can count on one hand the number that I thought were truly sociopathic. And the fact that I had religious convictions was generally accepted, sometimes admired, and often simply ignored, but was almost never the subject of scorn.

Latter-day Saints can sometimes have a bit of a persecution complex because of the severe abuses heaped upon the Church earlier in its history. But on that occasion in the operating room I think I got off relatively easy. And I acknowledge that this doctor wasn’t really targeting me because of my faith; that was just a convenient soft spot to poke. The real issue at play was his apparent desire to assert dominance, through intimidation and insult, over someone who was already his underling. Pimping is considered fair game in medical education, but mocking a student’s personal religious beliefs is definitely out of bounds.

Tolerance for the beliefs and practices of others has long been a tenet of our philosophy. Church founder Joseph Smith included it among the 13 Articles of Faith:

“We claim the privilege of worshiping Almighty God according to the dictates of our own conscience, and allow all men the same privilege, let them worship how, where, or what they may” (Articles of Faith, number 11, see also Doctrine and Covenants section 134 for a longer discussion of our beliefs about religious freedom).

This is not just lip service. We acknowledge that our beliefs are different in some important ways from other religions, and that those differences can sometimes lead to misunderstandings and conflicts with others. But if we wish to be tolerated then we must first extend the gift of tolerance to others. Latter-day Saints are among the most outspoken proponents of religious liberty for all people, because “the same principle which would trample upon the rights of the Latter-day Saints would trample upon the rights of the Roman Catholics, or of any other denomination who may be unpopular and too weak to defend themselves” (Joseph Smith, 1843).

I will use the terms “freedom of conscience” and “religious liberty” more or less interchangeably here. Both terms imply not only the freedom to hold personal moral convictions, but also the freedom to act upon them without infringing on the essential rights of others. Liberty and tolerance are two sides of the same coin; you can’t have one without the other. Genuine tolerance is reciprocal.

How does this bedrock belief in freedom of conscience affect my work as a doctor? It frees me to see all of my patients first and foremost as human beings, not defined by their beliefs or lifestyles which are often quite different from mine. My job is to diagnose and manage neurological illnesses with empathy and compassion for my patients, offering them the support and the education they need to cope with their condition. I have had very positive doctor-patient relationships with many people of different faiths or with no faith, and people with various genders and sexual orientations. Simply put, all of these categories that we use to define ourselves don’t matter very much in my line of work. The diseases that I treat don’t seem to care much whether you are Southern Baptist, Presbyterian, Muslim, or agnostic, or whether you are married or in a cohabiting relationship, or what you consider your gender to be. So in the context of my clinical work I don’t really have to care about these issues either. In a previous post, Sandra Babb, RN approached this topic from the perspective of a nurse, and her discussion applies equally well here.

Of course some medical conditions are more common in some demographic groups, sometimes for biological reasons which we don’t entirely understand or can’t control, and sometimes as a direct result of choices that people make. The risk of stroke is increased by smoking. Neuropathy happens more often to people who have poorly-controlled diabetes, which is usually related to personal choices about diet and exercise. Traumatic brain injury is more likely to occur in people who are intoxicated. HIV and syphilis infection, both of which are transmitted through high risk sexual activity, can exert myriad effects on the nervous system. These relationships are facts in medical science, but they are not judgments. They do not give me license to berate my patients for their disease-related behaviors. Of course I will talk with my stroke patients about their smoking status, but that discussion takes the form of a pep talk for smokers who are trying to quit. I will encourage my diabetic or obese patients to exercise and eat healthy foods, but I understand that not all of them can or will. I don’t often diagnose diseases which are the direct result of high risk sexual activity, but doctors who do may appropriately discuss with their patients ways to decrease those risks.

But what we must not do is attempt to impose our own moral standards on our patients. Freedom of conscience is a sacred right. I expect my patients to be respectful of my beliefs, and so I respect and tolerate theirs.

I remember an elderly gentleman whom I saw in my clinic many times. He was a retired Evangelical Christian minister, and had been very successful in building his congregation over many decades. He knew that I was a Latter-day Saint, and I can only guess what his feelings might have been about my faith. When I was serving as a missionary and met people like him I would instinctively brace myself for the attack which I knew was almost certainly coming. But from this good man it never came. He knew that any religious differences we had were not important in the context of our relationship as doctor and patient. Our deliberate decision to tolerate one another allowed us to have very positive interactions which were never sullied by ill feelings, and I was grateful to this man for the goodness in his heart.

As always, Jesus is our best example of tolerance. He could simultaneously love the sinner while rejecting the sin. His clear judgment against sinful behavior was issued with respect and genuine concern for the sinner (as illustrated in Luke 7:36-50, John 8:3-11, and many other passages). He also consistently rebuked and corrected the smallness of heart and tendencies to rash judgment among his disciples (see Luke 9:51-56 for an example). Those who follow the Lord can and should speak out against sin, but we should always follow his example of showing love for sinners because the love that we show for one another is the greatest sign of our own Christianity: “By this shall all men know that ye are my disciples, if ye have love one to another” (John 13:35).

Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist. The header image was taken from

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